[Daily bifractionated split course radiotherapy in non-anaplastic, non-metastatic, non-resectable cancers of the lung. A preliminary study. Apropos of 129 cases].
Between January 1980 and December 1986, 326 cases of lung cancer were treated at the Centre de Télégammathérapie Saint-Dominique in Marseille. 232 cases, including 129 non-anaplastic, non-metastatic, unresectable tumours, received bifractionated treatment; each patient received at least one cycle of radiotherapy (8% of stage I, 41% of stage II, 25% of stage IIIa, 26% of stage IIIb, 70% of squamous carcinomas, median age: 69.1 years). The protocol consisted of two cycles of 20 Gy in 10 fractions of 5 to 7 days, 2 sessions per day separated by an interval of 6 hours and with a split of 3 weeks. One hundred and twenty two patients received two cycles ("TDF 89" = 55 Gy) and, in view of the excellent tolerance, 44 patients received, 6 to 8 weeks later, a third cycle consisting of either 12 Gy in 6 fractions over 3 days ("TDF 110" = 68 Gy) or 16 Gy in 8 fractions over 4 days ("TDF 120" = 74 Gy) to a target volume reduced to the tumour zone. For the overall group, the tolerance was good or very good in 90% of cases, the median survival was 8.2 months, the objective response rate was 86% with a complete response rate of 11% and the loco-regional failure rate at the time of death was 41%. The important prognostic factors were: general status, oncological contraindications to surgery, the type of response (complete response: median survival: 12 months), the limited or advanced stage (median survival: 11.3 months versus 6.3 months) and the number of cycles, in particular: a third cycle was well tolerated and increased the survival (the median survival increased from 8 to 11 months, p = 0.01), allowed a curative dose to be administered, as the rates of complete, by more than 75%, partial and objective remission increased significantly from 9 to 16%, from 42 to 73%, from 77 to 82% and from 86 to 98% respectively. Fibroscopy returned to normal or was limited to simple infiltration in 80% of cases and the local failure rate was 36%. A comparative study of 364 patients treated with monofractionation at the CHU Timone is underway and the preliminary results appear to be very favourable.
Duchamp
C
C
Centre de télégammathérapie Saint-Dominique, Marseille.
Bernardini
J
J
Balozet
P
P
Juin
P
P
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors
Radiothérapie en bi-fractionnement quotidien (BFQ) "en split course" dans les cancers du poumon non anaplasiques, non métastasés, non résécables. Etude préliminaire. A propos de 129 observations.